Epidemiology and clinical profile of pathogens responsible for the hospitalization of children in Sousse area, Tunisia

Abstract

This study aimed to identify a broad spectrum of respiratory pathogens from hospitalized and not-preselected children with acute respiratory tract infections in the Farhat Hached University-hospital of Sousse, Tunisia. Between September 2013 and December 2014, samples from 372 children aged between 1 month and 5 years were collected, and tested using multiplex real-time RT-PCR by a commercial assay for 21 respiratory pathogens. In addition, samples were screened for the presence of Streptococcus pneumoniae 16S rDNA using real-time PCR. The viral distribution and its association with clinical symptoms were statistically analyzed. Viral pathogens were detected in 342 (91.93%) of the samples of which 28.76% were single positive and 63.17% had multiple infections. The most frequent detected viruses were rhinovirus (55.64%), respiratory syncytial virus A/B (33.06%), adenovirus (25.00%), coronavirus NL63, HKU1, OC43, and 229E (21.50%), and metapneumovirus A/B (16.12%). Children in the youngest age group (1–3 months) exhibited the highest frequencies of infection. Related to their frequency of detection, RSV A/B was the most associated pathogen with patient’s demographic situation and clinical manifestations (p<0.05). Parainfluenza virus 1–4 and parechovirus were found to increase the risk of death (p<0.05). Adenovirus was statistically associated to the manifestation of gastroenteritis (p = 0.004). Rhinovirus infection increases the duration of oxygen support (p = 0.042). Coronavirus group was statistically associated with the manifestation of bronchiolitis (p = 0.009) and laryngitis (p = 0.017). Streptococcus pneumoniae DNA was detected in 143 (38.44%) of tested samples. However, only 53 samples had a concentration of C-reactive protein from equal to higher than 20 milligrams per liter, and 6 of them were single positive for Streptocuccus pneumoniae. This study confirms the high incidence of respiratory viruses in children hospitalized for acute respiratory tract infections in the Sousse area, Tunisia.

Epidemiology of severe acute respiratory infections from hospital-based surveillance in Madagascar, November 2010 to July 2013

“…While RV is considered as the common cold virus, the present study showed that this virus accounted for 14% of total SARI cases. This finding highlights the potential role of RV in public health like other authors already postulated [ 35 – 37 ].…”

Molecular characterization of respiratory syncytial virus circulating in Tunisia between 2015 and 2018

“…Among 1417 investigated patients, 394 (27.8 %) were found to be positive for RSV by DIFA. This annual rate of detection is similar to those reported in Tunisian studies conducted between 2000–2002 and 2013–2014 (23.1 and 33.1 %, respectively [22, 23]). However, a higher detection rate was reported in the South of Tunisia between 2009 and 2010 (42.7 %) [24].…”

Viral infections in wheezing disorders

“…These results are of relevance, as previous studies have suggested that RSV is a risk factor for the later development of asthma and allergy [13] and that anti-RSV monoclonal antibody prevents recurrent wheeze in an atopy-dependent manner [14]. Given that RSV infection is most prevalent in the first year or two of life [15], the Japanese study suggests that preventing infection in these early years has effects further into childhood, but that this effect is independent of atopy. More detailed studies to examine immune system responses to anti-RSV monoclonal antibody therapy are now needed for further progress to be made in understanding the role of RSV in wheeze and asthma.…”